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卢旺达医学生强化外科模拟周的实施。

Implementation of an Intensive Surgical Simulation Week for Medical Students in Rwanda.

机构信息

Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.

Harvard Medical School, Boston, Massachusetts.

出版信息

J Surg Res. 2024 Oct;302:232-239. doi: 10.1016/j.jss.2024.07.041. Epub 2024 Aug 6.

Abstract

INTRODUCTION

Simulation-based training often fails to meet the needs of low- and middle-income countries with limited access to high-cost models. We built on an existing surgical simulation curriculum for medical students in Rwanda and assessed students' experience.

METHODS

Based on a contextual simulation-based education curriculum that was piloted in 2022, our team designed and delivered an intensive week-long surgical simulation course for medical students. We increased interactive clinical scenarios using high-fidelity mannequins, improved and added benchtop models for training, and incorporated a new postcourse assessment of students' experiences using a survey on the first Kirkpatrick level to determine sessions with the highest utility. Modules included informed consent, preoperative patient preparation, trauma simulations, and procedural skills. The final day focused on integrating and applying skills learned throughout the week in an interactive circuit.

RESULTS

Thirty-six students participated in the 5-d simulation course and 24 completed an end of course survey. When asked about their exposure to simulation prior to the course, 20/24 (83%) students reported "a lot" and 4/24 (17%) reported "a little", 24/24 (100%) strongly agreed that simulation is a valuable educational tool and 23/24 (96%) felt that the week enhanced their knowledge and skills to "a great extent". The modules with the highest self-rated level of engagement were the interactive trauma simulations, knot-tying and suturing practice and competition, and a model-based session on cutaneous lesions. The lowest ranked session was the interactive circuit on integrated skills.

CONCLUSIONS

Implementing a locally-informed and locally-sourced surgical simulation curriculum is feasible and effectively engages medical students in low-income settings.

摘要

简介

基于模拟的培训通常无法满足那些难以获得高成本模型的低收入和中等收入国家的需求。我们在卢旺达为医学生建立了一个现有的外科模拟课程,并评估了学生的体验。

方法

基于 2022 年试点的基于情境的模拟教育课程,我们的团队为医学生设计并提供了为期一周的强化外科模拟课程。我们使用高保真人体模型增加了互动临床情景,改进并增加了用于培训的台式模型,并结合了对学生体验的新课后评估,使用第一级柯克帕特里克评估来确定具有最高效用的课程。模块包括知情同意、术前患者准备、创伤模拟和程序技能。最后一天的重点是在互动电路中整合和应用整个星期所学的技能。

结果

36 名学生参加了为期 5 天的模拟课程,24 名学生完成了课程结束后的调查。在被问及他们在课程前接触模拟的情况时,20/24(83%)名学生报告“很多”,4/24(17%)名学生报告“一点”,24/24(100%)名学生强烈同意模拟是一种有价值的教育工具,23/24(96%)名学生认为这一周极大地增强了他们的知识和技能。自我评估参与度最高的模块是互动创伤模拟、打结和缝合练习和竞赛,以及基于模型的皮肤损伤课程。排名最低的课程是综合技能的互动电路。

结论

在低收入环境中实施本土化和本地化的外科模拟课程是可行的,并且可以有效地吸引医学生参与。

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